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Oxford University Hospitals NHS Foundation Trust
Head2Head

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Your questions - answered

Once you are home there can be many questions.. We hope this page may help to answer some of the most common ones.

Recovery

Recovery from an SAH is an individual process and there is no set pattern so can be difficult to predict how long recovery will take. There is no set timescale and each person is different. You can expect to have good days and bad days during your recovery.

What precautions should I be taking now?

  • STOP smoking if you smoke
  • Ensure your blood pressure is well controlled
  • Keep hydrated

Tiredness, restlessness and fatigue

It is common to experience severe tiredness, especially in the first few months after the haemorrhage. Activities like going to the shops, watching TV, reading or talking with your friends you may find exhausting. This is because your brain has to concentrate hard to process everything going on around you and becomes tired very quickly. It is your body's way of telling you to slow down. You may also find that you have difficulty sleeping at night and can only sleep for short periods. If you wake in the night and cannot get back to sleep, try getting up and making a hot drink rather than lying there worrying about not sleeping. It can help to have a daily routine. Try to get up and go to bed at the same time each day.

Headaches

Headaches following your discharge from hospital are common but usually ease with time. They tend not to be as severe as when you had the haemorrhage and can often be controlled with painkillers like paracetamol and codeine. Fatigue is closely associated with headaches and might become worse when you are tired. Again, this is your body's way of telling you to slow down.

Unusual sensations

People often say that they experience odd or unusual sensations in their brain which are different from headaches. They are very difficult to explain but people sometimes describe them as "tickly" and something like water running across the surface of the brain. No-one knows why these sensations occur but they are common and are nothing to be concerned about. They will usually ease in time.

Sight

Vision can be affected in some people. You may have blurring, blind areas, black spots, or double vision. If you do have visual problems as a result of the haemorrhage, you might be referred to an eye specialist. If you already wear glasses or contact lenses it is a good idea to wait for two or three months after the haemorrhage before having your eyes tested again. This gives time for your vision to settle.

Memory

Memory and concentration problems are common following an SAH. It can be difficult to concentrate for long periods of time and can make simple tasks like reading a book or making a cup of tea difficult and frustrating. Try to break tasks down into small steps so you only have to concentrate for short periods of time before taking a rest. Following SAH certain parts of your memory might be affected and you may not remember much about the haemorrhage or hospital admission. You might find that you can remember things that happened to you a few years ago but find it difficult to remember new information like the name of the person you have just met. Many people find that their memory improves with time, although it might never be quite as good as it was before the haemorrhage.

Helpful tips to aid with your memory

  • Keep a book or a diary and write down all the important things you need to remember
  • Post-it notes in bright colours can be really useful memory aids as you can stick them everywhere.
  • Try not to get too anxious or stressed as this will make it more difficult to remember information.
  • Use an alarm clock to help you to remember to do something like make a telephone call or go to an appointment.

Emotions

Many people find it difficult coming to terms with having had an SAH. You might feel depressed, tearful, angry or anxious for no apparent reason. These feelings can be physical (related to what has happened to your brain), emotional (a reaction to the traumatic experience), or both. Many of these changes are temporary and will improve over time.

Feelings and worries

It is natural to feel anxious and to worry about the future, especially when you are back at home. Many people are concerned that the haemorrhage might happen again, although this is very unlikely. It can be difficult recovering from such a major life event. The first few weeks and months can be a very intense time and you might find that friends and family treat you differently. Everybody has different ways of coping. If you are struggling to come to terms with what has happened it might be helpful to keep a simple diary of your thoughts and your physical recovery. This will also help you to record how you are improving as time passes. It is also common for people to become irritable or angry after an SAH, but they might not be aware that their behaviour or personality has changed. Irritability or angry outbursts can be very difficult for friends or family to cope with. Communication and talking openly is important at this time.

Everyday activities

Can I drive?

Driving regulations change twice a year. Your team at the hospital will discuss with you if you need to inform the DVLA about your haemorrhage. Regulations are stricter for HGV (Heavy Goods Vehicle) or PSV (Public Service Vehicle) licenses.

Can I fly?

Depending on your recovery, there is nothing to stop you from flying once you are fit enough to do so. Ensure you are adequately hydrated and have appropriate travel insurance. You are advised to avoid flying for at least ten days after a craniotomy and up until six weeks after a subarachnoid haemorrhage, as you are unlikely to feel well enough to travel. The clips and coils will not affect you going through airport security scanners.

Can I play sport/swim?

Contact sports should be avoided for approx 6 months after this time you should discuss with your specialist about returning. Other exercise is fine and tolerance can be built up gradually. Swimming is fine once any wounds have healed, but it is a good idea to be accompanied for the first few months while the risk of having seizures is at its highest.

Can I have sex?

You can resume sexual activity as soon as you feel ready.

When can I go back to work?

It is common for people who have had an SAH to take several months off work. Many people find it helpful to go back part-time or for a few hours each week before returning to full-time work. It depends on the individual.

Will I ever be the same again?

It can take many months after an SAH to feel that life is getting back to "normal" and people often ask whether they will ever be the same again. This is a very difficult question to answer as everyone' recovery is different. There is nothing that you can do to speed up your recovery. The main advice is to take it easy and listen to what your body is telling you.

Many of these questions were answered with the help of the Brain and Spine Foundations literature on Subarachnoid Haemorrhage. See the link below for further information and advice.

Brain & Spine Foundation SAH booklet